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Individual
MR. VANCE RAY WARDEN I
Active
Individual
MR. VANCE RAY WARDEN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0987
MS
363LF0000X
Family Nurse Practitioner
F0113056
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123522
—
MS
01
—
350000283
PTAN
MS
Enumeration date
03/09/2007
Last updated
03/11/2022
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